Objective To explore the mechanism of inhibitory effect of dimethyl sulfoxide (DMSO) on the hyperplasia of the fibrous capsule around the tissue expander. Methods The experimental model was established in rats as follows: after implanting the expander on the back of rats, 30 % DMSO or normal saline was injected into the expander. The former was classified as experimental group, and the latter as control group. The cystic wall was resected after the skin and soft tissues were expanded. In situ hybridization and the immunohistochemical staining were used to determine the expression of typesⅠand Ⅲ of collagen and procollagen mRNA in the cystic walls. Results It was found that both the typeⅠand Ⅲ of collagen content and the expressing quantity of mRNA of procollagen in the cystic wall of the experimental group were less than those of control group. Conclusion The results imply that the mechanism that DMSO inhibits the expression of typesⅠand Ⅲ of collagen in the fibrous cystic wall may be achieved through down-regulating the genetic expression of procollagen in the fibroblasts.

Objective To investigate the molecular mechanisms of beta3 adrenoceptor subtypes mediating rat detrusor relaxation. Methods Cyclic adenosine monophosphate(cAMP) was detected by radioimmunoassay, the effects of the cyclic AMP inhibitor SQ 22,536 and the cyclic AMP dependent protein kinase inhibitor H 89 on the relaxation elicited by ISO and BRL37344A in the rat ditrusor were investigated based on pharmacological evaluations. Results After the stimulating of ? AR by ISO, the levels of intracellular cAMP was increased, and the relaxation mediated via ISO could be partly inhibited by SQ 22,536 or H 89 The concentrations of intracellular cAMP had no changes in the presence of SQ 22,536 or H 89, and the relaxant responses to BRL37344A was not affected by SQ 22,536 or H 89. Conclusion The effects of ISO via? AR on relaxant responses to detrusor was mediated mainly by the cyclic AMP independent pathway and in part by the cyclic AMP dependent pathway, but cAMP PKA pathway were not involved in the beta3 adrenoceptor signaling pathway

Eight cases of hypothyroid myopthy admitted in Zhanshan Hospital Xiamen University from 1995 to 2011 were retrospectivrely analyzed.The main clinical features were proximal muscle weakness,susceptibility to fatigue,and elevation of muscle enzymes.Electromyography revealed no specific findings.All patients obtained clinical recovery after thyoid hormone replacement.Hypothyroid myopathy should be considered in cases of muscle weakness and elevation of muscle enzymes.

Objective To investigate the predictive value of plasma gelsolin in the prognosis of patients with ST-sgement elevation myocardial infarction ( STEMI ) and undergone primary percutaneous coronary intervention ( PCI ) .Methods The study included 206 patients with STEMI and undergone primary PCI, 148 patients with stable angina pectoris and received elective PCI and 80 healthy volunteer as the health population (NP) control.Blood samples were taken at admission on day 1, 3, 5, 7 and 9 to determine the plasma gelsolin level .Patients′baseline clinical characteristics , blood biochemistry tests results , details of operation and their cardiovascular risk factors were recorded .Major adverse cardiovascular events (MACE) within one year were recorded.Results (1) Compared to the stable angina group and the NP group, the level of plasma gelsolin of STEMI patients were obviously decreased at various time points ( all P<0.05 ) .There were no statistical differences between the stable angina group and the NP group .( 2 ) Patients with STEMI were catagorized into MACE group (n=78) and non-MACE group (n=128) according their follow up record in 1 year.The level of plasma gelsolin in patients with MACE were lower than the non-MACE group ( P <0.05 ) with the minimum value detected on day 7.Among patients complicated with MACE (n=78), they were further devided into the deceased group (n=18) and the survival group (n=60).Plasma gelsolin levels were lower in the deceased group with satistical differences found on day 5, 7 and 9.(3) Single factor Logistic regression analysis showed that the level of plasma gelsolin on day 7 was independent risk factor of MACE within one year ( P =0.014 ) .( 4 ) Setting the cutoff value of plasma gelsolin on day 7 as 21.7 mg/L,the sensitivity and speciticity for the MACE in STEMI patients treated with primary PCI within one year were 82.1%and 81.4%respectively , with the area under the receiver operator characteristic curve ( ROC ) was 0.854 ( 95% confidence interval 0.732 -0.961 , P <0.01 ) . Conclusions Plasma gelsolin levels are correlated with the severity of STEMI lesions and plasma gelsolin can be used as predicting factor of prognosis .

OBJECTIVE To study the therapeutic effect of arytenoid within-shift combining with recurrentlaryngeal nerve (RLN) anastomosis to ansa cervicalis for patients with long-term unilateral vocal cord paralysis (UVCP) . METHODS Twelve patients with traumatic RLNs paralysis were studied. The courses of injury varied from 3 to 22 years. RLN was anastomosed to ansa cervicalis and arytenoid was within-shifted on ipsilateral side in all patients. Therapeutic efficacy was evaluated by laryngoscope, strobe-laryngoscope, voice evaluation, voice acoustics parameter analysis, and laryngeal electromyography (LEMG) . RESULTS The voice was improved in all cases after arytenoid within-shift immediately. The mean values of voice acoustics parameters (jitter, shimmer, NNE) were significantly smaller and maximum phonation time (MPT) were significantly longer after operation compared with those of before treatment. Laryngoscope showed that arytenoid was significantly within-shifted. The glottic posterior chink vanished in 9 cases and reduced in 3 cases. The voice resumed normal, obviously improved, improved and no improved were found in 9、 3、0、0 cases respectively 12 months after operation. The mass and tension of all treated vocal cords may become the same as the contralateral normal vocal cords, thus resuming symmetric vibration of the vocal cords. The reinnervation of the RLNs were approved by LEMG in these patients whose RLNs were restored. CONCLUSION Arytenoid within-shift combining with RLN anastomosis to ansa cervical can restored normal voice in patients with long-term UVCP.

Objective To assess the correlation of promoter methylation of DAPK1,RAR-β and MGMT with cervical lesions from cytology to histology,and to reveal the clinical value of DNA methylation in diagnosis of cervical intraepithelial neoplasia (CIN).Methods A total of 103 random-selected cervical samples were collected from residual liquid-based cytology specimens after clinical use in cytopathological diagnosis in outpatient clinic of obstetrics and gynecology,Peking Union Medical Collage Hospital from March 2010 to October 2010.Informed consent was obtained from each woman before the initiation of the study.The methylation seusitive-high resolution melt (MS-HRM) assay was used to evaluate promoter methylation of three genes ( DAPKI,RAR-β and MGMT) in 103 biopsy-confirmed liquid-based cervical cytology samples.Methylation levels and high-risk HPV DNA loading ( HC Ⅱ values) were analyzed in relation to both cytological and histological diagnosis.Results The methylation level of all three genes showed significant difference among the different cytological groups ( P =0.000,0.011 and 0.002,respectively).The methylation level of DAPK1 and RAR-β showed significant difference among the different histological groups ( P =0.000 and 0.021 ),while there was no significant difference for MGMT.DAPK1 methylation levels was 1.47％ in the CIN Ⅱ/high-grade precancerous lesions group,and 20.98％ in the normal/CIN I groups ( P =0.000 ),but there was no significant difference between CIN I/high-grade precancerous lesions and normal/CIN Ⅰ groups for RAR-β and MGMT.The combination of DAPK1/HR-HPV loading showed a sensitivity of 0.825 and an area under the receiver operating characteristic curve (ROC) curve (AUC) of 0.695 as diagnostic methods for detecting CIN Ⅱ/high-grade precancerous lesions.Conclusions DNA methylation such as DAPK1 and RAR-β,in combination with HR-HPV detection,may serve as biomarkers to detect CIN Ⅱ/high-grade precancerous lesions.Detection of methylated DNA from liquid-based cervical cytology specimens is technically feasible with the MS-HRM assay.

Objectives To explore therapeutic effect,indication and timing of nerve decompression for traumatic recurrent laryngeal nerve injury inducing vocal cord paralysis. Methods A total of 42 patients with recurrent laryngeal nerve injury inducing vocal cord paralysis within six months, were divided into nerve decompression group (15 cases), end to end anastomosis of recurrent laryngeal nerve group (six cases) and nonsurgical treatment (21 cases). Nerve decompression was performed in the patients who were operatively found to have compressing sutures or compression due to cicatricial hypertrophy. Results In 13 patients with a course less than four months, nerve decompression restored normal functional adductory and abductory motion of the vocal cord in 11 patients and motionless in two. Although functional motion of vocal cord was not seen in two patients with a course less than four months and two longer than four months, the mass and tension of the reinnervated vocal cord became much the same as the contralateral normal vocal cord, thus resuming symmetric vibration of the vocal cords and physiological phonation. End-to-end anastomosis of recurrent laryngeal nerve failed to restore motion of the glottis. Nevertheless, the procedures enabled adductory muscles to be reinnervated and then restored normal voice. Although nonsurgical treatment improved severe hoarseness, the vocal cord didn't restore normal functional motion of the vocal cord and normal voice. Conclusions Early and mid-stage recurrent laryngeal nerve decompression may restore normal motion of the vocal cord. End-to-end anastomosis of recurrent laryngeal nerve enables adductory muscles to be reinnervated and thus restores normal voice.

Objective To investigate laryngeal reinnervation for recurrent laryngeal nerve injury caused by thyroid surgery. Methods Included in this series were 42 patients with recurrent laryngeal nerve injury, undergoing nerve decompression in 8 cases, end-to-end anastomosis of recurrent laryngeal nerve in 6, anastomosis of main branch of ansa cervicalis to recurrent laryngeal nerve in 21, end-to-end anastomosis of recurrent laryngeal nerve in 6 cases, phrenic nerve graft combined with nerve muscular pedicle (NMP) technique or nerve decompression in 7. All cases were subjected to preoperative and postoperative videolaryngoscopy, voice recording, acoustic analysis and electromyography. Results In 5 patients with unilateral injury and with a course less than four months, nerve decompression restored functional adductory and abductory motion of the vocal cord. Although functional motion of vocal cord was still absent in two patients receiving nerve decompression with a course longer than 4 months and in one less than 4 months, and in all cases with unilateral vocal cord paralysis receiving ansa cervicalis anastomosis and end to end anastomosis of recurrent laryngeal nerve, these procedures did result in symmetric vibration of the vocal cords and physiological phonation. Good inspiratory abductent motion of the glottis was observed on the reinnervated sides by the phrenic nerves in 6 cases with bilateral vocal cord paralysis and the vocal cord excursion was from 3 to 5 mm. On the opposite reinnervated sides, 2 cases with nerve decompression restored functional adductory and abductory motion of the vocal cord; while 4 cases with NMP technique restored only slight abductent motion or no motion. These patients have achieved sufficient airway so that exercise to tolerance for daily activities is adequate without a tracheotomy. In no case was the voice weakened, no was there any problem with aspiration. Conclusions Nerve decompression seems to be the best procedure in laryngeal reinnervation; Main branch of ansa cervicalis technique achieves satisfactory reinnervation of adductor muscles; Phrenic nerve graft yields more satisfactory vocal cord abductory motion than NMP technique. Selection of the laryngeal reinnervation protocols should depend on the course, severity, type of nerve injury.

OBJECTIVE:To observe therapeutic efficacy and safety of Rupi sanjie capsules in the treatment of mammary gland hyperplasia after minimally invasive rotation and surgical. METHODS:A total of 180 patients with mammary gland hyperplasia or mammary gland hyperplasia combined with mammary fibroma were selected retrospectively from general surgery department of the First Affiliated Hospital of Soochow University during May 2015 to May 2017. They were divided into control group(n＝90)and observation group (n＝90) according to medication methods. Both groups received minimally invasive rotation and surgical treatment. After operation,control group was given Tamoxifen citrate tablets 10 mg orally,twice a day. Observation group was given Rupi sanjie capsules 2.12 g orally,3 times a day. Two groups stopped taking medication during menstruation,and both groups were treated for 8 weeks. Clinical efficacies of 2 groups were observed,and the levels of VEGF,FGF and MVD,the occurrence of ADR were observed before and after treatment. RESULTS:The total response rate of observation group(95.56%) was significantly higher than that of control group(86.67%),with statistical significance(P＜0.05). Before treatment,there was no statistical significance in the levels of VEGF,FGF and MVD between 2 groups (P＞0.05). After treatment,the levels of VEGF,FGF and MVD in 2 groups were significantly lower than before treatment,and the observation group was significantly lower than the control group,with statistical significance(P＜0.05). No obvious ADR was found in 2 groups during treatment. CONCLUSIONS:After minimally invasive rotation and surgical,Rupi sanjie capsules shows significant therapeutic efficacy for mammary gland hyperplasia,can reduce the levels of VEGF,FGF and MVD with good safety.

Objective:To investigate the implementation procedures and dosimetric verification of the first patient treated with total body irradiation (TBI) based on volumetric modulated arc therapy (VMAT).Methods:Two sets of CT images were acquired under the head-in first and foot-in first to contour the planning target volume (PTV) of the cranial and caudal segments to accomplish the treatment of the whole body length, on which two interrelated plans of 5 subsequent isocenters with a total of 15 VMAT fields were performed to cover all PTVs. The plans were prescribed to ensure 90% PTV dose coverage with a total dose of 12 Gy in 6 fractions. Firstly, a dose optimization was performed on the caudal CT images, then the cranial CT images were optimized based on the dose distribution of the caudal CT images. The evaluation of the final treatment plan was carried out based on a plan sum of both two sets of images. The parameters of PTV and organs at risk (OARs) were measured by dose volume histograms from the accumulated plan. The quality assurance comprised the verification of the VMAT plans for each individual isocenter via Delta4 phantom. The dose distribution in the overlapped region between two adjacent central fields was verified with EBT3 film. The absolute dose at the overlapped region between two images was measured via Pinpoint chamber. In vivo dosimetry on the patient′s skin was monitored by MOSFET dosimeters. The results of planning parameters and treatment duration were analyzed. Results:The mean doses of two segments of PTVs were 12.45 Gy and 12.37 Gy. The mean dose for the lung was 10.8 Gy. The machine unit (MU) and mean treatment delivery time were 2 883 MU and 24.3 min, and the mean total time per fraction was 121 min. The mean 3%/3 mmγ-analysis pass rate for each isocenter VMAT plan was (99.74±0.42)%, and the mean 5%/5 mmγ-analysis pass rate for the overlapped region was (90.11±2.72)%. The average deviation of absolute dose in the overlap region of the caudal and cranial images was (3.6±0.4)%. In vivo measurement of 8 points on the patient showed that the dose of each region was ranged from 1.57 Gy to 2.04 Gy. Conclusion:According to the results of dosimetric verification, TBI based on multi-isocenter VMAT can be applied in clinical practice, which remains to be improved in terms of dose distribution, measurement results and clinical efficiency.